Federal Innovations in Emergency Medical Services, Management, and Operations
EMS World New Orleans, LA
October 3-7, 2016
ASPR Mission
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Our Mission:
“Lead the country in preparing for, responding to, and
recovering from the adverse health effects of emergencies and disasters by supporting our communities’ ability to
withstand adversity, strengthening our health and
response systems, and enhancing national health
security.”
ASPR Organizational Chart
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Secretary of Department of
Health and Human Services (HHS)
President of the United States
(POTUS)
ASPR Works With Partners from Local Communities to Global Institutions
ASPR has a variety of stakeholders and partners in the community which helps enable a more robust response to emergencies and planning in steady state.
• Public health • Congress • Private Sector • Academia • Faith-based community
Organizations • Global Institutions • Inter-governmental • Research Institutes • State, Local, Tribal
governments • Emergency Medical
Services • Various Other Associations
Operational Response to Events
Events come in “all shapes and sizes”, and are both expected and unexpected!
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Emergency Support Function (ESF)-8 is the mechanism
for Federal assistance to supplement State, tribal, and local resources in response to a public health and medical disaster, potential or actual Public health and medical care needs Behavior health needs Veterinary and/or animal health issues
HHS Coordinates Federal Public Health and Medical Response
National Disaster Medical System (NDMS)
Mission is to temporarily supplement Federal, State, and Local response capabilities by funding, organizing, training, equipping, and deploying a specialized and focused range of public health and medical personnel/capabilities.
DMAT, DMORT, NVRT teams
HHS Response Assets Support Local/State Needs
HHS Response Assets Support Local/State Needs
US Public Health Service (USPHS) Commissioned Corps
Rapid Deployment Force (RDF) Team Mental Health Team
Medical Reserve Corps (MRC)
National network of local groups of volunteers supporting local health departments respond to community health needs
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Medical Shelter Support Disaster Behavioral Health General Shelter Support (Human or
Animal) EOC Support Vaccinations/Mass Dispensing Hospital ACS/Med Surge Wellness Checks
Radiological Reception Centers Search and Rescue Volunteer Reception Center Mass Casualty Evacuation Call Center/Communications Support Epidemiology/Surveillance Support Animal/veterinary care
Emergency Response
International Issues Travel screening &
quarantine Disease Transmission International Response
Domestic Issues Coordination of response
(elected officials, hospitals, EMS, police/fire, EM, DOT, waste management/disposal)
Public Information Responder safety & PPE Health System Preparedness
Response Example: Ebola
U.S Strategy was predicated on four key goals:
1. Controlling the epidemic at its source in West Africa; 2. Mitigating second-order impacts, including blunting the
economic, social, and political tolls in the region; 3. Engaging and coordinating with a broader global
audience; and 4. Fortifying global health security infrastructure in the
region and beyond.
Response Example: Ebola
ASPR engaged with FEMA, Regional Partners, and State and locals to ensure a successful response in Louisiana.
Areas of focus: DMAT and surge needs Pharmacy and Hospital status EPAP Healthcare Coalition outreach and communications Shelters Mental Health Services Child Services EMPOWER Impacts to aging adults and those who depend on medical equipment in the home
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Recent Response: Louisiana Flooding
What is HHS/ASPR doing?
Assisting state and locals Vaccine and Medical Counter Measure development and clinical trials Working with the interagency Developing plans Sharing information and promoting awareness Providing aid to Puerto Rico (now through PHE Declaration)
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On the Forefront: ZIKA
On the Forefront: Zika and Puerto Rico
Current UCG Structure and rotational staff On-Ground and deployable assets Synchronize interagency efforts as well as
coordination among Federal and Commonwealth partners
Media Coverage and sending coordinated messages
Vector Control Coordination Behavioral Mental Health Empower the Commonwealth to enable long term
management
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HHS Programs Support Community Needs
CMS Section 1135 Waiver HHS Secretary may waive or modify certain Medicare, Medicaid,
CHIP, and HIPAA requirements
Emergency Prescription Assistance Program (EPAP) EPAP provides co-pay coverage of prescription and DME for
uninsured or underinsured victims
Advanced Registration and Credentialing (ESAR-VHP) System allows states to register and confirm credentials of
volunteer health professionals pre-event
Initiatives and Partnerships: Healthcare Coalitions Private Sector Engagement
New CMS Rule Centers for Medicare & Medicaid Services (CMS) recently
finalized a rule to establish consistent emergency preparedness requirements for health care providers participating in Medicare and Medicaid.
Rule requires certain participating providers and suppliers
to plan for disasters and coordinate with federal, state, tribal, regional, and local emergency preparedness systems to ensure that facilities are adequately prepared to meet the needs of their patients during disasters and emergency situations. This also helps ensure patient safety.
Effective as of November 16, 2016 Implementation date of November 16, 2017
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HHS Programs Support Community Needs
PREP Act
Issued by the Secretary of the Department of Health and Human Services
PREP Act Declaration provides: • “immunity from liability for any loss caused, arising out of,
relating to, or resulting from administration or use of countermeasures to diseases, threats and conditions determined in the Declaration to constitute a present or credible risk of a future public health emergency”.
Liability immunity applies to entities and individuals involved in
the development, manufacture, testing, distribution, administration, and use of medical countermeasures described in a Declaration.
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ASPR OEM Fusion:
Mission
Fusion’s mission is to provide enhanced situational awareness and support
informed decision making for OEM & ASPR leadership during public health
emergencies and disaster events.
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Fusion Capabilities / Inventory
Geographic Information Systems (GIS) /
GeoHEALTH Platform Social Media Research / Babel Street,
Hootesuite, Now Trending Fusion Analytics / Statistical Analysis Software
(SAS) Demographic Reports / Community Analyst Bed Availability / HAvBED
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GIS / GeoHEALTH
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FLEXIBLE: Data and Models:
Open source data services (NOAA, USGS) easily added and displayed
Restricted data (healthcare infrastructure, census, OEM internal data)
Layered Models (storm surge, hurricane wind speed, CBRN plumes)
Ability to load/view local data (CSV, TXT, KML, etc.)
Can pre-configure maps to improve access to information
ACCESSIBLE: Ability to share live, dynamic maps and data Several open data sets Functions on all types of devices (iOS, Android, PC) Small learning curve
2013 2014 2015 2016 Flu 2013 Inauguration Winter Storms State of the Union Post-Sandy Mold H7N9 Boston Bombings Oklahoma Tornados West Nile Virus Colorado Forest Fires Hepatitis A outbreak Heat MLK 50th Anniversary Fukushima Radiation Colorado Flooding MERS
MERS State of the Union Super Bowl XLVIII WV Chemical Leak Winter Storms Unaccompanied Children Peace Officer’s Memorial July 4th Hurricane Arthur Ebola
Ebola Flu Meningitis (Oregon) Winter Storms Typhoon Dolphin (Guam) Peace Officer’s Memorial HIV outbreak (Indiana) HPAI H5N2 Extreme Heat July 4th Papal Visit UCC shooting San Bernardino shooting
State of the Union Aliso Canyon Methane Leak 4th of July Peace Officers Memorial Flint Water Crisis Nuclear Summit Orlando Mass Shooting Zika RNC DNC LA Flooding
Social Media Research
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HHS emPOWER Initiative
Using Federal Health Data and Mapping to Advance Emergency Preparedness, Response, Recovery and Resilience
ASPR EMPOWER Initiative Mission
The mission is to provide readily
meaningful, consumable and actionable data, maps, and tools to advance
preparedness, inform and support response and recovery operations and decision-making, and to mitigate health system
stress and adverse health outcomes in at-risk populations in every community.
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HHS emPOWER Initiative
Pre-Event Emergency Planning (De-identified):
• Population-Based Situational Awareness • Emergency Planning Activities & Plans • Develop Systems, Processes & Triggers • Identify Resources for Scenarios • Sets Stage for Life-Saving Outreach • Other Considerations
Emergency Response & Notification (De-identified/Individual):
• Activate Emergency Plans ─ Population Based ─ Individual Outreach
• Deploy Emergency Response Assets • Activate Communications Network • Other Considerations
HHS emPOWER Initiative:
Integrating Public Health, Emergency Management, Healthcare, & Aging Systems
ASPR TRACIE
• ASPR TRACIE is a healthcare emergency preparedness information gateway that ensures that all stakeholders—at the federal, state, local, tribal, and territorial government levels in nongovernmental organizations and in the private sector—have access to information and resources to improve preparedness, response, recovery, and mitigation efforts. Each domain (TR, AC, and IE) provides users with unique support.
• ASPR TRACIE will fill gaps in healthcare system preparedness capabilities by providing timely, innovative ways to share information and promising practices during planning efforts. In the dynamic environment of a disaster, ASPR TRACIE will leverage resources to better integrate support and will serve as a force multiplier by improving information sharing and minimizing duplication of effort.
ASPR TRACIE: Three Domains • Self-service collection of audience-tailored materials • Subject-specific, SME-reviewed “Topic Collections” •Unpublished and SME peer-reviewed materials
highlighting real-life tools and experiences
•Personalized support and responses to requests for information and technical assistance
•Accessible by toll-free number (1844-5-TRACIE), email ([email protected]), or web form (ASPRtracie.hhs.gov)
•Area for password-protected discussion among vetted users in near real-time
•Ability to support chats and the peer-to-peer exchange of user-developed templates, plans, and other materials
ASPRtracie.hhs.gov 1-844-5-TRACIE [email protected]
The Biomedical Advanced Research and Development
Authority (BARDA), within HHS ASPR, provides an integrated, systematic approach to the development and purchase of the necessary vaccines, drugs, therapies, and diagnostic tools for public health medical emergencies.
BARDA Divisions: Division of Chemical, Biological, Radiological and Nuclear Medical Countermeasures Influenza Division Division of Regulatory & Quality Affairs Strategic Science and Technology
HHS ASPR BARDA
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Seasonal & Pandemic Influenza
Preparedness
All HazardsPreparedness
CBRN Preparedness
Emerging Emerging Diseases Diseases
PreparednessPreparedness
BARDA and the All-Hazards Principle
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Seek FDA Approval
Protein Sciences Corp.
Recombinant-based Influenza Vaccine
GlaxoSmithKline
H1N1 & H5N1 Vaccines w/ Adjuvant
Anthrax Antitoxins
HGS/GSK
Botulinum Antitoxin
Cangene
Covidian
Next-Generation Portable Ventilators
Flu/RSV POC Diagnostic 3M/Focus
Novartis Cell-based Influenza Vaccine
Influenza IV Antiviral Drug
Emergent
Amgen
ASPR on the Web
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ASPR TRACIE: asprtracie.hhs.gov
HHS emPOWER Map: www.phe.gov/empowermap